Does patellar resurfacing matter in robotic-assisted total knee arthroplasty with functional alignment principles?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Total knee arthroplasty (TKA) aims to restore knee function and alignment.
• Restoring the anterior knee compartment and patellar mechanics remains a challenge in TKA.
• Robotic-assisted TKA with functional alignment (FA) principles offers a new approach to optimize surgical outcomes.

Purpose of the Study:

• To evaluate the functional consequences of anterior compartment restoration in robotic-assisted TKA using FA principles.
• To specifically assess the impact of patella resurfacing versus non-resurfacing on functional outcomes.
• To compare radiographic and clinical outcomes between TKA with and without patellar resurfacing.

Main Methods:

• Retrospective comparative study of 268 patients undergoing robotic TKA for varus osteoarthritis.
• Patients were divided into two groups: patellar resurfacing (study) and no patellar resurfacing (control).
• Outcomes were assessed using radiographic measurements, Knee Society Score (KSS), Forgotten Joint Score (FJS), and Kujala Score at a minimum 2-year follow-up.

Main Results:

• Patellar tilt and translation significantly improved in the resurfaced group compared to the non-resurfaced group.
• No significant difference in patellar offset was observed between the groups.
• KSS knee and function scores were higher in the non-resurfaced group, while Kujala and FJS scores were similar.

Conclusions:

• Both patellar resurfacing and non-resurfacing approaches yield comparable clinical outcomes in robotic-assisted TKA with FA.
• Radiographic outcomes for the anterior knee compartment improve with both techniques.
• The decision for patellar resurfacing in TKA should be individualized.